Early Pregnancy Cravings, Dietary Intake, and Development ...



BACKGROUNDApproximately 45-90% of US women report new cravings sometime during pregnancyGestational diabetes (GDM) affects approximately 4-7% US pregnant women GDM increases risk for pregnancy complications, preeclampsia, emergency C-section, macrosomiaFactors that increase risk for GDM include higher weight status, physical activity, smoking during pregnancy, family history, and dietary intake of saturated fat or dietary fiberA possible mechanism in which cravings could influence GDM risk is through changes in dietOBJECTIVEAssess associations of new cravings during pregnancy with simultaneous nutrition intake and with subsequent development of abnormal glucose intoleranceDESIGN/SETTING3543300229870002,022 mothers from Project Vita, a prospective cohort recruited from medical practices in eastern Massachusetts between 1999 to 2002Type of pregnancy craving (sweet, salty, savory, starchy, nonsweet dairy and other) was assessed base on self-report at mean gestation of 10.9 weeksMAIN OUTCOME MEASURESAt mean gestation of 11.8 weeks, participants completed a self-administered food frequency questionnaire to report frequency of consumption of more than 140 specific food and beverages during the present pregnancyIncident isolated hyperglycemia (blood glucose >/ 140 mg/dL on nonfasting oral glucose challenge but had normal results on oral glucose challenge), impaired glucose tolerance (one abnormal result on glucose tolerance test) and GDM (two or more abnormal results) development was determinedSTATISTICAL ANALYSISLinear regression used to analyze cross-sectional relationships between pregnancy cravings and dietary intakeMultinomial logistic regression used to analyze prospective relationships between pregnancy cravings and development of abnormal glucose intolerance diagnosisRESULTSApproximately 45% of participants reported new cravings for specific foods that started during pregnancyA total of 17.8% developed some kind of abnormal glucose tolerance in which approximately 5.8% of participants developed GDMSweet cravings were associated with increased intake of sucrose and fat (total and saturated) Salty cravings were associated with increased fiber intake and decreased saturated fat intakeSavory cravings were associated with increased omega-3 fatty acid intakeStarchy cravings were associated with increased carbohydrate intake and decreased total fat intakeSalty cravings were associated with lower risk for GDM (adjusted odds ratio 0.34)Craving sweet, savory or salty foods was not associated with abnormal glucose toleranceDid not find that dietary fiber intake during pregnancy was associated with GDMSTRENGTHS AND LIMITATIONSLarge sample sizeWomen recruited have health insurance, research may not be generalizable to populations of low socio-economic statusTypes and proportions of craving types may not be the same in other populationsComplexity of categorizing mixed dishesWomen tend to experience a large amount of cravings during the third trimester; therefore results may underestimate total amount of women experiencing cravings during the entire pregnancyCONCLUSIONSNew cravings in the first trimester of pregnancy is associated with dietary intake Cravings for salty food during pregnancy may be protective against later risk for abnormal glucose toleranceCraving sweet foods does not appear to increase risk for abnormal glucose toleranceREFERENCEFarland, L.V., Rifas-Shiman, S.L., & Gillman, M.W. (2015). Early pregnancy, cravings, dietary intake, and development of abnormal glucose tolerance. Journal of the Academy of Nutrition and Dietetics. 115(12); 1958-64. ................
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